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Low-Dose Cyclosporine A in the Treatment of Disabling Morphea

Ralf U. Peter, MD; Thomas Ruzicka, MD; Fritjof Eckert, MD
[+] Author Affiliations

Department of Dermatology University of Munich Frauenlobstrasse 9-11 W-8000 Munich 2, Germany


Arch Dermatol. 1991;127(9):1420-1421. doi:10.1001/archderm.1991.01680080160029
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To the Editor.—  Cyclosporine A is an immunosuppressive agent that has been used primarily in transplantation medicine. It has also been used in a variety of dermatologic diseases, including severe psoriasis vulgaris,1 pyoderma gangrenosum,2 granuloma anulare,3 vitiligo,4 Behçet's disease,5 pemphigus vulgaris,6 and alopecia areata.7 In lupus erythematosus, its use has met with limited success (unpublished observations).Disabling morphea is a rare disease that is often resistant to most forms of treatment; intravenous administration of penicillin, steroids, and nonsteroidal anti-inflammatory drugs (NSAIDs) are recommended.6We describe two male patients, 50 and 40 years of age, respectively, who presented with severe, rapidly progressive disabling morphea, and who showed marked improvement on treatment with cyclosporine A, after treatment with NSAIDs, high-dose intravenous penicillin (both cases), diuretics, and high daily doses of methyl prednisolone (case 1 only) had been ineffective.

Report of Cases.—Case 1.— 

REFERENCES

Mueller W, Hermann B.  Cyclosporin A for psoriasis . N Engl J Med . 1979;;301:555.
Elgart G, Larson KA, Stoyer P, Davis B.  Effective treatment of pyoderma gangraenosum with cyclosporin: a report of five cases . J Invest Dermatol . 1989;;92:424.
Brown MD, Ellis C, Voorhees JJ.  Cyclosporine A: a review of its dermatologic applications . Semin Dermatol . 1987;;6:2-9.
Gupta AK, Ellis C, Nickoloff BJ, et al.  Cyclosporine in the treatment of inflammatory and noninflammatory dermatoses . Arch Dermatol . 1990;;126: 339-350.
Büsch R, Ruzicka T, Donhauser G.  Cyclosporin-A Therapie des Morbus Behçet . Hautarzt . 1990;;41:329-331.
Heule F, van Joost T, Beukers R.  Cyclosporine in the treatment of lupus erythematosus . Arch Dermatol . 1986;;122:973-974.
Braun-Falco 0, Plewig G, Wolff HH. Dermatologie und Venerologie . New York, NY: Springer Verlag NY Inc; 1984;.
Sharpe RJ, Arndt KA, Bauer SJ, Maione TE.  Cyclosporine inhibits basic fibroblast growth factor driven proliferation of human endothelial cells and keratinocytes . Arch Dermatol . 1989;;125:1359-1362.
Miescher PA, Favres H, Mihatsch MJ, Chatelenat F, Huang YP, Zubler R.  The place of cyclosporin A in the treatment of connective tissue diseases . Transplant Proc . 1988;;23( (suppl 4) ):224-237.
Wörle B, Hein R, Krieg T, Meurer M.  Cyclosporin in localized and systemic skleroderma: a clinical study . Dermatologica . 1990;;181:215-220.

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Mueller W, Hermann B.  Cyclosporin A for psoriasis . N Engl J Med . 1979;;301:555.
Elgart G, Larson KA, Stoyer P, Davis B.  Effective treatment of pyoderma gangraenosum with cyclosporin: a report of five cases . J Invest Dermatol . 1989;;92:424.
Brown MD, Ellis C, Voorhees JJ.  Cyclosporine A: a review of its dermatologic applications . Semin Dermatol . 1987;;6:2-9.
Gupta AK, Ellis C, Nickoloff BJ, et al.  Cyclosporine in the treatment of inflammatory and noninflammatory dermatoses . Arch Dermatol . 1990;;126: 339-350.
Büsch R, Ruzicka T, Donhauser G.  Cyclosporin-A Therapie des Morbus Behçet . Hautarzt . 1990;;41:329-331.
Heule F, van Joost T, Beukers R.  Cyclosporine in the treatment of lupus erythematosus . Arch Dermatol . 1986;;122:973-974.
Braun-Falco 0, Plewig G, Wolff HH. Dermatologie und Venerologie . New York, NY: Springer Verlag NY Inc; 1984;.
Sharpe RJ, Arndt KA, Bauer SJ, Maione TE.  Cyclosporine inhibits basic fibroblast growth factor driven proliferation of human endothelial cells and keratinocytes . Arch Dermatol . 1989;;125:1359-1362.
Miescher PA, Favres H, Mihatsch MJ, Chatelenat F, Huang YP, Zubler R.  The place of cyclosporin A in the treatment of connective tissue diseases . Transplant Proc . 1988;;23( (suppl 4) ):224-237.
Wörle B, Hein R, Krieg T, Meurer M.  Cyclosporin in localized and systemic skleroderma: a clinical study . Dermatologica . 1990;;181:215-220.

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